Patients with low back pain who are depressed are more likely to be prescribed opioids, and to be prescribed higher doses, a new study finds.
Low back pain is a leading cause of disability in the United States and the most common reason for opioid prescriptions, the researchers said.
“There is strong evidence that depressed patients are at greater risk for misuse and overdose of opioids,” said study senior author Dr. John Markman. He directs the University of Rochester Medical Center’s Translational Pain Research Program, in New York.
The analysis of nationwide data on nearly 5,400 people from 2004 to 2009 found that patients with back pain who screened positive for depression were more than twice as likely to be prescribed an opioid painkiller. Over a year’s time, they also got more than twice the typical dose, the study found.
The researchers said learning more about these patterns can improve understanding of the U.S. opioid epidemic. It will also help evaluate the success of efforts to control prescription opioid abuse, they said.
Markman said more study is needed to understand the risks and benefits of prescribing painkilling drugs to patients with low back pain and depression.
He noted that low back pain is the condition most often studied to approve new pain medications.
“Excluding depressed patients may lead clinicians who rely on these studies to underestimate the risks of opioids when they are prescribed for low back pain in routine practice,” Markman said in a Rochester news release.